DR. JOSEPH EDWIN RICKETTS JR. (NPI# 1235243437) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235243437 |
| Entity Type | Individual |
| Full Name | DR. JOSEPH EDWIN RICKETTS JR. |
| Credential | DHSC, PA-C |
| Practice Address |
4100 W 3rd St Vamc Dayton OH 45428-9000 |
| Practice Telephone | 9372686511 |
| Practice Fax Number | 9372675316 |
| Mailing Telephone | 9372686511 |
| Mailing Fax Number | 9372675316 |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2010-04-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
50.000585 | OH | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | PHYSICIAN ASSISTANT LICENSURE | 50.000585 | 01 |
| PA | PENNSYLVANIA PHYSICIAN ASSISTANT LICENSURE | MA001798L | 01 |
| Street Address |
4100 W 3RD ST VAMC |
| City | DAYTON |
| State | OH |
| Zip Code | 45428-9000 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861496549 | Andrew T Su | Internal Medicine | 4100 W 3rd St, Dayton, OH 45428-9000 | 2005-06-09 |
| 1578162038 | Olivia Marie Falter | Audiologist | 4100 W 3rd St, Dayton, OH 45428-9000 | 2020-10-25 |
| 1295334084 | Sarah M Miller | Music Therapist | 4100 W 3rd St, Dayton, OH 45428-9000 | 2020-10-22 |
| 1366049918 | Chadwick Ryan Watiker | Social Worker | 4100 W 3rd St, Dayton, OH 45428-9000 | 2020-10-07 |
| 1174137301 | Danielle Marie Pike | Psychologist | 4100 W 3rd St, Dayton, OH 45428-9000 | 2020-09-04 |
| 1497368856 | Dinah Callender | Registered Nurse | 4100 W 3rd St, Dayton, OH 45428-9000 | 2020-08-26 |
| 1801405352 | Alice Wei Ho | Pharmacist | 4100 W 3rd St, Dayton, OH 45428-9000 | 2020-07-29 |
| 1801413356 | Sarah Teresa Hierath | Pharmacist | 4100 W 3rd St, Dayton, OH 45428-9000 | 2020-07-01 |
| 1942823349 | Sloane Rudolf | Optometrist | 4100 W 3rd St, Dayton, OH 45428-9000 | 2020-05-20 |
| 1720600331 | James Douglas Boodt | Student in an Organized Health Care Education/Training Program | 4100 W 3rd St, Dayton, OH 45428-9000 | 2020-05-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407414527 | Punyawat Laohakanjanasiri | Dentist | Dayton Va Medical Center/dental Services, 4100 W Third, Dayton, OH 45428 | 2019-06-04 |
| 1942716303 | John Korea Lee | Pharmacist | 4100 W. 3rd Street, Attn: Pharmacy Call Center 408pcc, Dayton, OH 45428 | 2017-12-21 |
| 1366876138 | Amber J Enterline | Pharmacist | 4100 W 3rd Street, Attn Pharmacy, Dayotn, OH 45428 | 2013-08-28 |
| 1114155793 | Jeffrey Michael Munn | Dentist | 4100 West 3rd St., Dayton V.a. Medical Center, Dayton, OH 45428 | 2009-06-23 |
| 1558516724 | Tawnyell Nikko Culpepper | Social Worker | 4100 Va Medical Center, Social Work Department Suite 122, Trotwood, OH 45428 | 2008-12-01 |
| 1255586376 | Prasad V Venkat | Physical Therapist | 4100 W.third Street, Dayton, OH 45428 | 2008-11-18 |
| 1457435687 | Reba E Crowell | Nurse Practitioner | 4100 West 3rd Street, Dayton, OH 45428 | 2006-10-24 |
| 1386728632 | Alicia Joann Weekes-johnson | Counselor | 4100 W Third St. Mhlc Bldg 302, Veterans Administration Medical Center, Dayton, OH 45428 | 2006-10-24 |
| 1497843049 | Margaret Irene Kruckemeyer | Nurse Practitioner | 4100 West Third Street (117), Va Medical Center, Dayton, OH 45428 | 2006-10-10 |
| 1003902545 | Mohamed Elmouelhi | Internal Medicine | 4100 W.third St., Dayton Vamc (11c), Dayton, OH 45428 | 2006-10-04 |
| Find all providers in zip 45428 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558668780 | Adam Joseph Thomas | Physician Assistant | 1 Elizabeth Pl Bldg G, Dayton, OH 45417-3445 | 2011-02-24 |
| 1790011724 | Andrew P Black | Physician Assistant | 6438 Wilmington Pike Ste 110, Dayton, OH 45459-7021 | 2009-10-27 |
| 1487722526 | Nancy Moyer Solada | Physician Assistant | 1989 Miamisburg Centerville Rd Ste 201, Dayton, OH 45459-3858 | 2006-11-30 |
| 1467417386 | James D. Welsh | Physician Assistant | 1427 Business Center Ct, Dayton, OH 45410-3300 | 2006-04-20 |
| 1417937558 | Anthony S Allen | Physician Assistant | 5 Pine Cone Rd, Suite 102, Dayton, NV 89403-7393 | 2006-01-17 |
| 1558353904 | Douglas Eulberg | Physician Assistant | 3075 Governors Place Blvd, Suite 120, Dayton, OH 45409-1323 | 2005-08-19 |
| 1730791146 | Shannon Hayes | Physician Assistant | 3535 Southern Blvd, Dayton, OH 45429-1221 | 2020-08-18 |
| 1164052395 | Andrew Conroy | Physician Assistant | 1 Wyoming St, Dayton, OH 45409-2722 | 2020-01-15 |
| 1396307138 | Aleesha Mae Schafers | Physician Assistant | 1 Childrens Plz, Dayton, OH 45404-1873 | 2019-07-02 |
| 1073079190 | Mckenzie Wheeler | Physician Assistant | 1 Childrens Plz, Dayton, OH 45404-1873 | 2019-02-13 |
| Find all providers in DAYTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.